The Amazon Comparison

[00:00] I have to say that I love Amazon. Now, understand, I am not a paid spokesman for Amazon and this is not a commercial for the Amazon website. But why do I love Amazon? Because if I want to buy something, I just put it in my cart and check out. Two clicks, done.

Let’s compare that to my role as a surgeon. If I want to order a post-operative medication for a patient in the hospital’s optimized EMR system, how many clicks does that take me? Well, depends on the day. First of all, I have to find a computer that actually works. Then I have to sit down and get the EMR to load on the computer. The time to do so varies with each computer. Then I have to sign in, maybe change my password again, and now I’m ready. Well, in theory. Ten clicks, five screens later, plus a two-factor identification that I have to acknowledge, the order may go through, assuming the patient’s correct pharmacy is present in the system. Now there’s some efficiency for you.

[01:03] We live in a world where consumer technology has relentlessly optimized friction out of our lives. Because let’s face it, the easier that they make it, the more that I will consume: online shopping, airfares, hotels, VRBOs, you name it. But in healthcare, we have spent billions of dollars on clinical workflow optimization that has actually added friction. And this discrepancy drives me crazy.

Okay, to be fair, it’s not all bad. We have managed to optimize things for the lawyers. The lawyers now have more data in the EMR systems than ever before, and that data they can use to search for errors and find ways to sue us. The billers and coders now have more data than ever to combat those insurance denials. But for physicians, not hardly. It’s more cumbersome for us every year. The workflow is a minefield. We have not optimized the workflow for the physician.

The Reality of “Automation”

[02:02] I’m Dr. Kevin Halow. Welcome again to Clinician Core Podcast. On today’s podcast, we’re going to talk about the Efficiency Illusion. We’re going to dissect why going digital has made us slower, why healthcare professionals such as our nurses are drowning in alert fatigue, and how we can finally build a workflow that actually works for us, not against us.

[02:26] The next time that you are in between patients or cases and you have a second or two, try Googling the words “healthcare workflow automation.” Something like this is going to come up: reducing administrative burdens, lowering operational costs, minimizing human errors, and enhancing patient experience in order to free up staff to focus on patient care, thereby decreasing burnout and improving quality care. Sounds great, right? Automation. We now have bots doing all the heavy lifting. I should feel good.

But let’s look at the reality from the trenches. What exactly have we automated? In my experience, most hospital workflows are designed to capture data, not to facilitate care. Every time I sit down to write my post-operative orders, the system forces me through a gauntlet of hard stops. For example:

  • Did you check the box for VTE prophylaxis? If not, you must provide a reason.
  • Have you confirmed the admission status yet?
  • Did you verify the allergy list again?
  • Or my favorite: the med reconciliation is not complete. You cannot move forward until you reconcile all medications.

Now, are those things important? Yes. But when the system interrupts my thought process 20 times in five minutes, that isn’t optimization; that is obstruction.

[04:00] Somehow we have confused patient care with data entry. The workflow is optimized to ensure that the hospital gets paid by capturing every comorbidity, but it comes at the cost of physician’s cognitive overload. I’m spending more brain power fighting the software than I’m thinking about my patient’s surgery. As a surgeon, the system has made me into one of the highest paid data entry specialists possible. Of course, we can always revisit those burnout statistics. Let’s see… the rates are pretty consistent at 48%. So much for automation bringing those numbers down. Maybe the administrators and the lawyers and the billers and the coders are benefiting from this software, but I don’t think that the rest of us are winning.

The “Shadow Workflow”

[04:47] Here is a secret that every clinician knows, but administrators hate to admit. Because the official optimized systems are so clunky, we’ve created a shadow workflow. Walk into the nursing section on the ward or the clinic. What do you see? You see sticky notes. You see scraps of paper with vitals written on them. You see patient reminders. You see nurses texting on personal cell phones.

Why? Because the official way—logging into the workstation, navigating four screens, typing a message—takes too long. Because trying to call the physician exchange or office and waiting on hold is a waste of time. So the staff invents workarounds. They use sticky note economy because paper is faster than the computer. They text on their personal cell phones because it’s easy and quick and reliable. This is the ultimate proof that our clinical workflow is broken. When the old way is faster than the new way, you haven’t optimized anything. You failed.

And the danger of the shadow workflow is that it’s invisible. That sticky note doesn’t get into the chart. That text message on a personal iPhone is not HIPAA compliant. We are forcing our best people to break the rules just to get their jobs done efficiently and effectively.

The Boy Who Cried Wolf: Alert Fatigue

[06:11] There is another specific aspect of this that I want to touch on as well, and that is alert fatigue. We’ve all seen it: the call light that keeps blinking, the buzzer that keeps buzzing. I was in the recovery room recently and there was an alarm beeping on the telemetry monitor next to the computer that I was using to dictate and do post-operative orders. Beep-beep. Beep-beep. Beep-beep. It just went on. It was steady, it was persistent, and it would not stop. There was something wrong with the patient in bay number three.

I watched as the staff just walked right by it. They did nothing. Ironically, it was not because they did not care; they just did not hear it. I know this because as soon as I pointed it out, one of the recovery room nurses instantly went to see the patient in bay number three to check on them.

So why the delay? Why did they not hear the alert? Because 99% of the alerts they get are just noise: blood pressure lead off, low battery, routine med due. We’ve optimized our systems to alert us about everything, which means we pay attention to nothing. This is the “boy who cried wolf” phenomenon engineered into our daily healthcare professional lives. Workflow optimization should mean silence. Why? Because it means that when the phone beeps, I actually know that this matters. If my phone buzzes 50 times a day for nothing, I’m just going to stop checking it. And the one time it actually buzzes for, I don’t know, lethal arrhythmia, I might miss it. We need systems that are smart enough to filter the noise. We don’t necessarily need to know everything that’s going on; we just need to know the important things that are going on.

The Solution: Clinician Core

[07:58] Okay, can we fix this? Can we move from the Efficiency Illusion to real efficiency? In order to do this, we have to stop building tools just for lawyers, billers, and administrators and start building tools for physicians, clinicians, and healthcare professionals. This is the philosophy behind Clinician Core. When we designed our platform, we had one rule: frictionless.

Clinician Core attacks these problems in three ways:

  1. The Click War: We stripped away all the hassle. It’s a communication tool that is easy to use. It connects you to each other and to everyone with whom you work.
  2. The Shadow Workflow: We’ve made the secure way the easy way to do work. It’s as fast as texting so you don’t need sticky notes anymore. It’s private—no more violating HIPAA—and it’s personal, the way we practice medicine.
  3. Alert Fatigue: We built in context. You don’t just get a beep, you get a priority level. You know instantly if this is a “review later” or “drop everything and go.”

[09:18] Clinician Core removes your cognitive overload. You have time to communicate, collaborate, re-engage, and reconnect. The end result is that you are now thinking about the patient, not the login screen. When you are re-engaged, you are part of the team again. You are efficient and effective. Practicing medicine becomes fun again. And that burnout? It finally starts to subside.

Conclusion and Call to Action

[09:44] If you are tired of clicking 10 times just to order an aspirin, or waiting on hold forever to give a nurse a Tylenol order, or tired of alarms that nobody hears, then it’s time to stop accepting the Efficiency Illusion. Clinician Core is built by physicians for physicians, clinicians, and healthcare professionals. We build it based upon real-world experience and feedback from people like you—physicians, surgeons, pharmacists, nurses, and allied healthcare professionals who are sick of the friction.

Head over to our website, cliniciancore.com. Join our waitlist for the new platform. By joining, you’re sending a signal that you want technology that optimizes for clinical care, not the administrative burden. If you enjoyed this podcast, in addition to checking out our website, please follow us on Spotify. You can also follow us on LinkedIn, Facebook, Instagram, YouTube, and Reddit.

I’m Dr. Kevin Halow. Let’s make the system work for us. See you next time on the Clinician Core podcast. Thanks for listening.